Consent to Listen and Record

CONSENT TO LISTEN AND RECORD

I, __________________________________________________,

Name of Person Giving Consent

of __________________________________________________,

Address

give consent to _____________________________________,

Name of Officer/Department

to listen to conversations I may have with the following person(s):

_____________________________________________________,

and to record the conversations to be later played in a court of law, if necessary.

I give this consent freely and voluntarily, without being threatened or coerced.

Signed _______________________________

Person Giving Consent

Date _______________________________

Witness _______________________________